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Celestino AO, Vieira SCF, Lima PAS, Rodrigues LMCL, Lopes IRS, França CM, Barreto IDDC, Gurgel RQ. Prevalence of intestinal parasitic infections in Brazil: a systematic review. Rev Soc Bras Med Trop 2021; 54:e00332021. [PMID: 34105625 PMCID: PMC8186895 DOI: 10.1590/0037-8682-0033-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/23/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Parasitic infections are considered a major public health problem due to their associated morbimortality and negative impact on physical and intellectual development, especially in the at-risk pediatric group. Periodic prophylactic administration of antiparasitic agents against soil-transmitted helminths is recommended by the World Health Organization (WHO) to control parasitic infections and disease burden. We aimed to evaluate the prevalence of intestinal parasitic infections in Brazil. METHODS We performed a systematic review by searching the literature found in the PubMed, LILACS, and SciELO databases, followed by a meta-analysis of the proportions from studies published in English, Portuguese, and/or Spanish from January 2000 to May 2018. This systematic review was registered in the PROSPERO database (CRD42018096214). RESULTS The prevalence of intestinal parasitic infections (protozoa and/or helminths) in Brazil was 46% (confidence interval: 39-54%), with 99% heterogeneity. Prevalence varied by region: 37%, 51%, 50%, 58%, and 41% in the Southeast, South, Northeast, North, and Central-West regions, respectively. Most studies (32/40) evaluated children (<18 years) and found an average prevalence of 51%. Children also had the highest prevalence in all four regions: Central-West (65%), South (65%), North (58%), Northeast (53%), and Southeast (37%). However, most studies evaluated specific populations, which may have created selection bias. Presumably, this review of intestinal parasitic diseases in Brazil includes the most studies and the largest population ever considered. CONCLUSIONS The prevalence of intestinal parasitic infections is high in Brazil, and anthelmintic drugs should be administered periodically as a prophylactic measure, as recommended by the WHO.
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Affiliation(s)
- Ariel Oliveira Celestino
- Universidade Federal de Sergipe, Programa de Pós-Graduação em Ciências da Saúde, Aracaju, SE, Brasil
| | - Sarah Cristina Fontes Vieira
- Universidade Federal de Sergipe, Programa de Pós-Graduação em Ciências da Saúde, Aracaju, SE, Brasil.,Universidade Federal de Sergipe, Departamento de Medicina, Aracaju, SE, Brasil
| | | | | | | | | | | | - Ricardo Queiroz Gurgel
- Universidade Federal de Sergipe, Programa de Pós-Graduação em Ciências da Saúde, Aracaju, SE, Brasil.,Universidade Federal de Sergipe, Departamento de Medicina, Aracaju, SE, Brasil
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2
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Olivares AIO, Leitão GAA, Pimenta YC, Cantelli CP, Fumian TM, Fialho AM, da Silva E Mouta S, Delgado IF, Nordgren J, Svensson L, Miagostovich MP, Leite JPG, de Moraes MTB. Epidemiology of enteric virus infections in children living in the Amazon region. Int J Infect Dis 2021; 108:494-502. [PMID: 34052409 DOI: 10.1016/j.ijid.2021.05.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To verify the frequency of viruses causing acute gastroenteritis (AGE) in association with the histo-blood group antigen (HBGA) and Rotarix™ vaccination coverage in children from the Amazon region. DESIGN Fecal and saliva samples were collected from children with AGE (n = 485) and acute respiratory infection (ARI) (n = 249) clinical symptoms. Rotavirus A (RVA), norovirus, human adenovirus (HAdV), and sapovirus (SaV) were verified in feces by molecular detection. Saliva samples were used for HBGA phenotyping/FUT3 genotyping. Blood group types, clinical aspects and Rotarix™ RVA vaccination data were recorded. RESULTS Norovirus remained the most prevalently detected cause of AGE (38%, 184/485 and ARI 21.3%, 53/249). High HAdV frequencies were observed in AGE children (28.6%, 139/485) and ARI children (37.3%, 93/249). RVA was the third most prevalent virus causing AGE (22.7%, 110/485 and ARI 19.3%, 48/249) and a low RV1 coverage (61%, 448/734) was verified. The SaV frequencies were lower (7.2%, 35/485 for AGE and 6.8%, 17/249 for ARI). Secretor children were HBGA susceptible to HAdV infection (OR 1.5, 95% CI 1.0-2.3; P = 0.04) but not to RVA, norovirus or SaV infection. CONCLUSIONS Norovirus could be considered the main etiological agent of AGE. No association was verified for HBGA susceptibility to RVA, norovirus and SaV. Secretor children showed a slight susceptibility to HAdV infection and the Le (a-b-) heterogeneous SNPs on the FUT3 gene.
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Affiliation(s)
- Alberto Ignacio Olivares Olivares
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Parasite Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Gabriel Azevedo Alves Leitão
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Sanitary Surveillance, National Institute for Quality Control in Health, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Yan Cardoso Pimenta
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Sanitary Surveillance, National Institute for Quality Control in Health, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Carina Pacheco Cantelli
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Tulio Machado Fumian
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Alexandre Madi Fialho
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Sergio da Silva E Mouta
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Isabella Fernandes Delgado
- Post-Graduate Program in Sanitary Surveillance, National Institute for Quality Control in Health, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Johan Nordgren
- Division of Molecular Virology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Lennart Svensson
- Division of Molecular Virology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Marize Pereira Miagostovich
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - José Paulo Gagliardi Leite
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil
| | - Marcia Terezinha Baroni de Moraes
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Fiocruz, Avenida Brasil, Rio de Janeiro, RJ, Brazil.
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Merino VR, Nakano V, Delannoy S, Fach P, Alberca GGF, Farfan MJ, Piazza RMF, Avila-Campos MJ. Prevalence of Enteropathogens and Virulence Traits in Brazilian Children With and Without Diarrhea. Front Cell Infect Microbiol 2020; 10:549919. [PMID: 33102252 PMCID: PMC7545120 DOI: 10.3389/fcimb.2020.549919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
The use of molecular diagnostics for pathogen detection in epidemiological studies have allowed us to get a wider view of the pathogens associated with diarrhea, but the presence of enteropathogens in asymptomatic individuals has raised several challenges in understanding the etiology of diarrhea, and the use of these platforms in clinical diagnosis as well. To characterize the presence of the most relevant bacterial enteropathogens in diarrheal episodes, we evaluated here the prevalence of diarrheagenic E. coli pathotypes, Salmonella spp., and Yersinia enterocolitica in stool samples of children with and without diarrhea using real-time quantitative PCR (qPCR). We found that the presence of genetic markers associated with bacterial pathogens was significantly higher in stool samples from the diarrhea group compared to the control (P < 0.001). Bacterial loads in samples positive for eae and aggR markers were also determined. Compared to samples from asymptomatic children, a significantly higher number of copies of the eae gene were found in diarrhea samples. Also, the presence of genetic markers associated with STEC strains with clinical significance was evaluated in eae-positive samples by high-throughput real-time PCR. The data presented herein demonstrated that asymptomatic children of an urban area in Brazil might be enteropathogen reservoirs, especially for STEC.
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Affiliation(s)
- Victor R Merino
- Laboratório de Anaeróbios, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade of São Paulo, São Paulo, Brazil
| | - Viviane Nakano
- Laboratório de Anaeróbios, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade of São Paulo, São Paulo, Brazil
| | - Sabine Delannoy
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, Food Safety Laboratory, Université Paris-Est, Champs-sur-Marne, France
| | - Patrick Fach
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, Food Safety Laboratory, Université Paris-Est, Champs-sur-Marne, France
| | - Gabriela G F Alberca
- Laboratório de Anaeróbios, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade of São Paulo, São Paulo, Brazil
| | - Mauricio J Farfan
- Departamento de Pediatría y Cirugía Infantil, Facultad de Medicina, Campus Oriente-Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | | | - Mario J Avila-Campos
- Laboratório de Anaeróbios, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade of São Paulo, São Paulo, Brazil
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Taborda RLM, Silva LAD, Orlandi PP, Batista FS, Rodrigues RS, Matos NB. CHARACTERIZATION OF ENTEROAGGREGATIVE ESCHERICHIA COLI AMONG DIARRHEAL CHILDRENIN WESTERN BRAZILIAN AMAZON. ARQUIVOS DE GASTROENTEROLOGIA 2019; 55:390-396. [PMID: 30785524 DOI: 10.1590/s0004-2803.201800000-84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/12/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Enteroaggregative Escherichia coli (EAEC) is one of the main acute and chronic diarrhea causes both in children and adults, mainly in developing countries. OBJECTIVE The aim of the present study is to characterize EAEC strains isolated from faecal samples and to identify genes potentially contributing to virulence, biofilm production and antimicrobial resistance in children admitted to a pediatric hospital in Porto Velho, Rondônia State. METHODS The total of 1,625 E. coli specimens were isolated from 591 children in the age group 6 years or younger who were hospitalized in Cosme and Damião Children Hospital in Porto Velho, between February 2010 and February 2012, with acute gastroenteritis. Colonies suggestive of E. coli were subjected to polymerase chain reaction testing in order to identify the virulence factors. The in vitro adhesion assays using HEp-2 adherence were tests. Biofilm detection through spectrophotometry and antimicrobial susceptibility tests were conducted in the disk diffusion method. RESULTS The mentioned study examined 591 stool samples from children with diarrhea. Diarrheogenic E. coli was found in 27.4% (162/591) of the children. EAEC was the diarreagenic E. coli most frequently associated with diarrhea 52.4% (85/162), which was followed by enteropathogenic E. coli 43.8% (71/162), enterotoxigenic E. coli 2.4% (4/162), and enterohemorrhagic E. coli 1.2% (2/162). The aggR gene was detected in 63.5% (54/85) of EAEC isolates; moreover, statistically significant correlation was observed among typical EAEC (aggR) and aatA (P<0.0001), irp2 (P=0.0357) and shf (P=0.0328). It was recorded that 69% (59/85) of the 85 analyzed EAEC strains were biofilm producers; 73% (43/59) of the biofilm producers carried the aggR gene versus 42.3% (11/26) of non-producers (P=0.0135). In addition, there was association between the aatA gene and biofilm production; 61% (36/59) of the samples presented producer strains, versus 19.2% (5/26) of non-producers (P<0.0004). Antibiotic sensitivity test evidenced that most EAEC were ampicillin 70.6% (60/85), sulfamethoxazole 60% (51/85), tetracycline 44.7% (38/85) and cefotaxime 22.4% (19/85) resistant. CONCLUSION As far as it is known, the present study is pioneer in Northern Brazil to investigate EAEC virulence factors and to show the antimicrobial susceptibility of EAEC strains isolated from children with diarrhea.
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Affiliation(s)
| | | | | | | | | | - Najla Benevides Matos
- Centro de Pesquisa em Medicina Tropical, Porto Velho, RO, Brasil.,Fundação Oswaldo Cruz, FIOCRUZ - Porto Velho, RO, Brasil
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Dainton C, Chu CH. A review of gastrointestinal protocols for primary care medical service trips (MSTs) in Latin America and the Caribbean. Int Health 2018. [PMID: 29522108 DOI: 10.1093/inthealth/ihy005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Gastrointestinal disorders are among the most common conditions encountered on short-term, primary care medical service trips (MSTs) in Latin America and the Caribbean (LAC), but their optimal management remains unclear. There have been no previous attempts to describe the protocols that Western volunteer clinicians use in managing these patients. Methods A systematic web search was used to identify organizations operating MSTs in LAC. Clinical protocols were downloaded from organizational websites, and organizations were contacted online to obtain those that were not publicly available. Protocols were analysed qualitatively, and content compared with existing international guidelines. Results Two hundred and twenty-five organizations were identified and contacted to obtain their clinical protocols, and the content of each protocol was qualitatively analysed. Twenty protocols were obtained, of which 75% (15/20) discussed dyspepsia, 65% (13/20) discussed parasites and 60% (12/20) discussed diarrhoea. The protocols infrequently included literature citations. Conclusion Gastrointestinal disorder protocols used by MSTs in LAC sometimes neglected important aspects of clinical management that are emphasized in international guidelines. This study is a first step in context-specific clinical guideline development for MSTs operating in LAC.
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Affiliation(s)
- Christopher Dainton
- Grand River Hospital, Kitchener, ON, Canada.,McMaster University, Hamilton, ON, Canada.,Medical Service Trip Inc., Toronto, ON, Canada
| | - Charlene H Chu
- Medical Service Trip Inc., Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
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6
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Ouermi D, Soubeiga D, Nadembega WMC, Sawadogo PM, Zohoncon TM, Obiri-Yeboah D, Djigma FW, Nordgren J, Simpore J. Molecular Epidemiology of Rotavirus in Children under Five in Africa (2006-2016): A Systematic Review. Pak J Biol Sci 2017; 20:59-69. [PMID: 29022996 DOI: 10.3923/pjbs.2017.59.69] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Group A human rotaviruses (RVA) are the most common causes of severe viral gastroenteritis in infants and young children worldwide. The available vaccines, while effective in Europe and North America have shown a reduced efficacy in Africa. One issue raised is the genetic variability of RVA. The objective of this study was to perform a literature review of molecular epidemiology to determine the prevalence of RVA genotypes circulating in Africa so as to establish a mapping of reliable data on these various genotypes. The search for articles was done from the National Institutes of Health (PUBMED) using three set of keywords. Articles were selected with inclusion criteria such as the date of publication, the age of the children, the sample size and the diagnostic techniques (standardized laboratory techniques). The data were imported into STATA SE version 11 software. Specific prevalence was estimated with Confidence Intervals (CI) of 95%. A total of 326 published studies were initially retrieved, out of which 27 studies were finally selected for the systematic review. The selected studies cover 20 African countries. The most encountered genotypes in Africa during this period were G1 (32.72%), followed by G2 (17.17%), G3 (9.88%), G9 (8.61%) and G12 (7.56%) among the G-types. The most common P-types were P[8] (48.71%) followed by P[6] (22.60%) and P[4] (11.58%) and the G1P[8] combination (22.64%) was the most encountered followed by G2P[4] (8.29%), G9P[8] (6.95%) and G2P[6] (5.00%). North Africa presented the highest prevalence of the P[8] genotype (65.70%). This review provides a comprehensive view of the current circulating rotavirus strains in Africa, which can be important in light of the new rotavirus vaccinations. Indeed, in Africa, the pursuit of national and continental studies for epidemiological surveillance of circulating rotavirus strains is vital for the promotion of future successful vaccines.
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Affiliation(s)
- D Ouermi
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - D Soubeiga
- Institut de Formation et de Recherche Interdisciplinaires en Santé (IFRIS), Ouagadougou, Burkina Faso
| | - W M C Nadembega
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - P M Sawadogo
- Institut de Formation et de Recherche Interdisciplinaires en Santé (IFRIS), Ouagadougou, Burkina Faso
| | - T M Zohoncon
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - D Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana
| | - F W Djigma
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - J Nordgren
- Division of Molecular Virology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Simpore
- University Saint Thomas d'Aquin, USTA, Ouagadougou, Burkina Faso
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Singh T, Das S, Ramachandran VG, Wani S, Shah D, Maroof KA, Sharma A. Distribution of Integrons and Phylogenetic Groups among Enteropathogenic Escherichia coli Isolates from Children <5 Years of Age in Delhi, India. Front Microbiol 2017; 8:561. [PMID: 28443072 PMCID: PMC5385330 DOI: 10.3389/fmicb.2017.00561] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/20/2017] [Indexed: 01/29/2023] Open
Abstract
Integrons by means of horizontal gene transfer carry multidrug resistance genes (MDR) among bacteria, including E. coli. The aim of this study was to determine the antibiotic resistance profiles and the genes associated with them, to gain insights in the distribution of phylogroups, prevalence, and characterization of class 1, 2 and 3 integrons among Enteropathogenic E. coli (EPEC) isolates, from children upto 5 years of age from Delhi and National Capital Region (NCR), India. A total of 120 E. coli isolates, including 80 from diarrheagenic E. coli (cases) and 40 from healthy isolates (controls) were recruited in this study. After isolation of E. coli, screening for EPEC was done by conventional multiplex PCR. Antibiotic suseptibility test was performed using disk diffusion method and further confirmed by minimum inhibitory concentration (MICs) by E-test. The presence and characterization of integrons and antimicrobial resistance genes were performed by PCR and DNA sequencing. Phylogeny determination was carried out by quadruplex PCR. EPEC strains were found in 64 of the 80 diarrheagenic cases, out of which 38 were MDR. In the 40 healthy controls, 23 were found to be EPEC strain, out of which only 2 were MDR. Amongst 80 diarrheagenic cases, class 1 integron were observed in 43 isolates, class 2 integron in 12 isolates and 9 isolates were found with co-existence of both. Similarly, in healthy controls; class 1 integron in 9 and class 2 integron in 7 isolates were observed with co-existence in 3 isolates. None of the isolates included class 3 integron. The dfr was the most commonly identified gene cassette within the integron-positive isolates. Phylogenetic studies showed considerable representation of phylogroup B2 in both diarrheagenic cases and healthy controls. This study reiterates the importance of class 1 integron predominantly for acquisition of antibiotic resistance genes among EPEC isolates. Furthermore, it also ascertains the possible association between multidrug resistance and presence of integrons. Approximately 91% of isolates were easily assigned to their respective phylogroups. Assessment of the relationship between antibiotic resistance and dominant phylogroups detected was also attempted. This study also highlights the increased burden of antimicrobial resistance in healthy controls.
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Affiliation(s)
- Taru Singh
- Microbiology, University College of Medical Sciences and Guru Teg Bahadur HospitalNew Delhi, India
| | - Shukla Das
- Microbiology, University College of Medical Sciences and Guru Teg Bahadur HospitalNew Delhi, India
| | - V G Ramachandran
- Dermatology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad GardenNew Delhi, India.,Department of Minimal Access and Bariatric Surgery, Fortis Flt. Rajan Dhall HospitalNew Delhi, India
| | - Sayim Wani
- Dermatology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad GardenNew Delhi, India.,Department of Minimal Access and Bariatric Surgery, Fortis Flt. Rajan Dhall HospitalNew Delhi, India
| | - Dheeraj Shah
- Pediatrics, University College of Medical Sciences and Guru Teg Bahadur HospitalNew Delhi, India
| | - Khan A Maroof
- Community Medicine, University College of Medical Sciences, and Guru Teg Bahadur Hospital, Dilshad GardenNew Delhi, India
| | - Aditi Sharma
- Vardhman Mahavir Medical College and Sardarjung HospitalNew Delhi, India
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Michelli E, Millán A, Rodulfo H, Michelli M, Luiggi J, Carreño N, De Donato M. Identification of enteropathogenic Escherichia coli in children with acute diarrheic syndrome from Sucre State, Venezuela. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2016; 36:118-127. [PMID: 27622632 DOI: 10.7705/biomedica.v36i0.2928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/11/2015] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Diarrheagenic Escherichia coli is an important causative agent of acute diarrheic syndrome. OBJECTIVE To identify clonal groups of enteropathogenic E. coli (EPEC), in 485 children with acute diarrhea aged 0 to 10 years attending health care centers in Arismendi, Benítez and Sucre municipalities, Sucre state, Venezuela, from March to December, 2011. MATERIALS AND METHODS After obtaining the informed consent, stool samples were collected. Escherichia coli was identified using standard coproculture methods and serology with polyvalent and monovalent antisera. DNA was isolated, and eae (intimin) and bfpA (bundlin) genes were amplified through two multiplex polymerase chain reactions (PCR). RESULTS The presence of bacterial infection was determined in 39.6% of coprocultures. The prevalence of E. coli was 54.7%; 82.9% of these isolates were positive by serology for the evaluated serogroups and serotypes, which were mostly identified in children between 0 and 2 years (37.9%); 48.6% of E. coli strains amplified the eae gene; of these, 58.8% were classified as typical EPEC (eae+ y bfp+). EPEC II was the most common serogroup (38.7%), with predominance of typical EPEC (60%). In positive strains for eae gene, the β intimin allele was the most frequently identified (74.5%). Only four strains with O157:H7 serotype were identified, which showed no PCR amplification of the eae and bfpA genes. CONCLUSION This study showed the importance of molecular tests to identify diarrheagenic E. coli strains causing clinical conditions of varying severity.
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Affiliation(s)
- Elvia Michelli
- Laboratorio de Genética Molecular, Instituto de Investigaciones en Biomedicina y Ciencias Aplicadas "Dra. Susan Tai", Universidad de Oriente, Cumaná, Sucre, Venezuela Laboratorio de Microbiología Clínica, Departamento de Bioanálisis, Universidad de Oriente, Cumaná, Sucre, Venezuela.
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Dias RCB, dos Santos BC, dos Santos LF, Vieira MA, Yamatogi RS, Mondelli AL, Sadatsune T, Sforcin JM, Gomes TAT, Hernandes RT. DiarrheagenicEscherichia colipathotypes investigation revealed atypical enteropathogenicE. colias putative emerging diarrheal agents in children living in Botucatu, São Paulo State, Brazil. APMIS 2016; 124:299-308. [DOI: 10.1111/apm.12501] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/27/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Regiane C. B. Dias
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Bruna C. dos Santos
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Luis F. dos Santos
- Centro de Bacteriologia; Instituto Adolfo Lutz (IAL); São Paulo SP Brazil
| | - Melissa A. Vieira
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Ricardo S. Yamatogi
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Alessandro L. Mondelli
- Departamento de Patologia Clínica; Faculdade de Medicina; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Terue Sadatsune
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - José M. Sforcin
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Tânia A. T. Gomes
- Departamento de Microbiologia, Imunologia e Parasitologia da; Universidade Federal de São Paulo (UNIFESP); São Paulo SP Brazil
| | - Rodrigo T. Hernandes
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
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Dey S, Bhattacharya D, Roy S, Nadgir SD, Patil A, Kholkute SD. Shewanella algae in acute gastroenteritis. Indian J Med Microbiol 2015; 33:172-5. [PMID: 25560029 DOI: 10.4103/0255-0857.148442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Shewanella algae is an emerging bacteria rarely implicated as a human pathogen. Previously reported cases of S. algae have mainly been associated with direct contact with seawater. Here we report the isolation of S. algae as the sole etiological agent from a patient suffering from acute gastroenteritis with bloody diarrhoea. The bacterium was identified by automated identification system and 16S rRNA gene sequence analysis. Our report highlights the importance of looking for the relatively rare aetiological agents in clinical samples that does not yield common pathogens. It also underscores the usefulness of automated systems in identification of rare pathogens.
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Affiliation(s)
| | | | - S Roy
- Department of Microbiology & Molecular Biology, Regional Medical Research Centre (Indian Council of Medical Research, Department of Health Research, Govt. of India), Nehru Nagar, Belgaum, India
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11
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Benevides-Matos N, Pieri FA, Penatti M, Orlandi PP. Adherence and virulence genes of Escherichia coli from children diarrhoea in the Brazilian Amazon. Braz J Microbiol 2015. [PMID: 26221098 PMCID: PMC4512055 DOI: 10.1590/s1517-838246120130917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The bacterial pathogen most commonly associated with endemic forms of childhood diarrhoea is Escherichia coli
. Studies of epidemiological characteristics of HEp-2 cell-adherent E. coli
in diarrhoeal disease are required, particularly in developing countries. The aim of this study was evaluate the presence and significance of adherent Escherichia coli
from diarrhoeal disease in children. The prevalence of LA, AA, and DA adherence patterns were determined in HEp-2 cells, the presence of virulence genes and the presence of the O serogroups in samples obtained from 470 children with acute diarrhoea and 407 controls in Porto Velho, Rondônia, Brazil. E. coli
isolates were identified by PCR specific for groups of adherent E. coli
. Out of 1,156 isolates obtained, 128 (11.0%) were positive for eae
genes corresponding to EPEC, however only 38 (29.6%) of these amplified bfpA
gene
.
EAEC were isolated from 164 (14.1%) samples; of those 41(25%), 32 (19%) and 16 (9.7%) amplified eagg
, aggA
or aafA
genes, respectively and aggA was significantly associated with diarrhoea (
P
= 0.00006). DAEC identified by their adhesion pattern and there were few isolates. In conclusion, EAEC was the main cause of diarrhoea in children, especially when the aggA
gene was present, followed by EPEC and with a negligible presence of DAEC.
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Affiliation(s)
- Najla Benevides-Matos
- Instituto de Pesquisas em Patologias Tropicais, Fundação Oswaldo Cruz, Porto Velho, RO, Brazil
| | - Fabio A Pieri
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, AM, Brazil
| | - Marilene Penatti
- Hospital Infantil Cosme e Damião, Secretaria de Estado da Saúde, Porto Velho, RO, Brazil
| | - Patrícia P Orlandi
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, AM, Brazil
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12
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Vasco G, Trueba G, Atherton R, Calvopiña M, Cevallos W, Andrade T, Eguiguren M, Eisenberg JNS. Identifying etiological agents causing diarrhea in low income Ecuadorian communities. Am J Trop Med Hyg 2014; 91:563-9. [PMID: 25048373 PMCID: PMC4155560 DOI: 10.4269/ajtmh.13-0744] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 06/16/2014] [Indexed: 12/26/2022] Open
Abstract
Continued success in decreasing diarrheal disease burden requires targeted interventions. To develop such interventions, it is crucial to understand which pathogens cause diarrhea. Using a case-control design we tested stool samples, collected in both rural and urban Ecuador, for 15 pathogenic microorganisms. Pathogens were present in 51% of case and 27% of control samples from the urban community, and 62% of case and 18% of control samples collected from the rural community. Rotavirus and Shigellae were associated with diarrhea in the urban community; co-infections were more pathogenic than single infection; Campylobacter and Entamoeba histolytica were found in large numbers in cases and controls; and non-typhi Salmonella and enteropathogenic Escherichia coli were not found in any samples. Consistent with the Global Enteric Multicenter Study, focused in south Asia and sub-Saharan Africa, we found that in Ecuador a small group of pathogens accounted for a significant amount of the diarrheal disease burden.
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Affiliation(s)
- Gabriela Vasco
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Gabriel Trueba
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Richard Atherton
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Manuel Calvopiña
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - William Cevallos
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Thamara Andrade
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Martha Eguiguren
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Joseph N S Eisenberg
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
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13
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Muhsen K, Cohen D, Levine MM. Can Giardia lamblia infection lower the risk of acute diarrhea among preschool children? J Trop Pediatr 2014; 60:99-103. [PMID: 24158113 DOI: 10.1093/tropej/fmt085] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
There are inconsistent findings concerning the role of Giardia lamblia in pediatric diarrhea. A prospective cohort study of the incidence of acute diarrhea among Israeli Arab preschool children offered the opportunity to examine the association between G. lamblia infection (at baseline) and subsequent diarrhea. Following baseline screening by light microscopy for the presence of Giardia in their stools, a cohort was assembled of 142 children who were followed between October 2003 and August 2004 for the incidence of diarrhea. Surveillance was performed through maternal interviews. At baseline, 21 children tested Giardia-positive. During the prospective surveillance, acute diarrhea occurred less often among Giardia-positive children (9.5%) than among children who were not infected with Giardia (26.5%). G. lamblia infection was associated with lower risk of acute diarrhea; adjusted odds ratio of 0.18 (95% confidence interval 0.04-0.93) (p = 0.041). This prospective study provides additional evidence that Giardia may lower the risk of subsequent acute diarrhea among preschool children.
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Affiliation(s)
- Khitam Muhsen
- Department of Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
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14
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Santos RVD, Nunes JDS, Camargo JADSA, Rocha EMMD, Fontes G, Camargo LMA. High occurrence of Entamoeba histolytica in the municipalities of Ariquemes and Monte Negro, State of Rondônia, Western Amazonia, Brazil. Rev Inst Med Trop Sao Paulo 2013; 55:S0036-46652013000300193. [PMID: 23740019 DOI: 10.1590/s0036-46652013000300010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/16/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. METHODS Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. RESULTS E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2 = 7.8; odds ratio = 2.4 (1.2 - 4.7)]. DISCUSSION Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. CONCLUSION The results indicate that E. histolytica infection is highly endemic in the studied areas.
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Affiliation(s)
- Rafael Vital dos Santos
- Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas, Maceió, AL, Brazil
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15
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Levine MM, Kotloff KL, Nataro JP, Muhsen K. The Global Enteric Multicenter Study (GEMS): impetus, rationale, and genesis. Clin Infect Dis 2013; 55 Suppl 4:S215-24. [PMID: 23169934 PMCID: PMC3502311 DOI: 10.1093/cid/cis761] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diarrheal disease remains one of the top 2 causes of young child mortality in the developing world. Whereas improvements in water/sanitation infrastructure and hygiene can diminish transmission of enteric pathogens, vaccines can also hasten the decline of diarrheal disease morbidity and mortality. From 1980 through approximately 2004, various case/control and small cohort studies were undertaken to address the etiology of pediatric diarrhea in developing countries. Many studies had methodological limitations and came to divergent conclusions, making it difficult to prioritize the relative importance of different pathogens. Consequently, in the first years of the millennium there was no consensus on what diarrheal disease vaccines should be developed or implemented; however, there was consensus on the need for a well-designed study to obtain information on the etiology and burden of more severe forms of diarrheal disease to guide global investment and implementation decisions. Accordingly, the Global Enteric Multicenter Study (GEMS) was designed to overcome drawbacks of earlier studies and determine the etiology and population-based burden of pediatric diarrheal disease. GEMS, which includes one of the largest case/control studies of an infectious disease syndrome ever undertaken (target approximately 12 600 analyzable cases and 12 600 controls), was rolled out in 4 sites in sub-Saharan Africa (Gambia, Kenya, Mali, Mozambique) and 3 in South Asia (Bangladesh, India, Pakistan), with each site linked to a population under demographic surveillance (total approximately 467 000 child years of observation among children <5 years of age). GEMS data will guide investment and help prioritize strategies to mitigate the morbidity and mortality of pediatric diarrheal disease.
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Affiliation(s)
- Myron M Levine
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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16
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Clark CG, Kruczkiewicz P, Guan C, McCorrister SJ, Chong P, Wylie J, van Caeseele P, Tabor HA, Snarr P, Gilmour MW, Taboada EN, Westmacott GR. Evaluation of MALDI-TOF mass spectroscopy methods for determination of Escherichia coli pathotypes. J Microbiol Methods 2013; 94:180-91. [PMID: 23816532 DOI: 10.1016/j.mimet.2013.06.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/20/2013] [Accepted: 06/20/2013] [Indexed: 11/30/2022]
Abstract
It is rapidly becoming apparent that many E. coli pathotypes cause a considerable burden of human disease. Surveillance of these organisms is difficult because there are few or no simple, rapid methods for detecting and differentiating the different pathotypes. MALDI-TOF mass spectroscopy has recently been rapidly and enthusiastically adopted by many clinical laboratories as a diagnostic method because of its high throughput, relatively low cost, and adaptability to the laboratory workflow. To determine whether the method could be adapted for E. coli pathotype differentiation the Bruker Biotyper methodology and a second methodology adapted from the scientific literature were tested on isolates representing eight distinct pathotypes and two other groups of E. coli. A total of 136 isolates was used for this study. Results confirmed that the Bruker Biotyper methodology that included extraction of proteins from bacterial cells was capable of identifying E. coli isolates from all pathotypes to the species level and, furthermore, that the Bruker extraction and MALDI-TOF MS with the evaluation criteria developed in this work was effective for differentiating most pathotypes.
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Affiliation(s)
- Clifford G Clark
- Enteric Diseases Program, Bacteriology and Enteric Diseases Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2 Canada.
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17
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Fialho OB, de Souza EM, de Borba Dallagassa C, de Oliveira Pedrosa F, Klassen G, Irino K, Paludo KS, de Assis FEA, Surek M, de Souza Santos Farah SM, Fadel-Picheth CMT. Detection of diarrheagenic Escherichia coli using a two-system multiplex-PCR protocol. J Clin Lab Anal 2013; 27:155-61. [PMID: 23424166 DOI: 10.1002/jcla.21578] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 01/04/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Diarrheagenic Escherichia coli (DEC) strains are important causes of diarrhea. However, they cannot be distinguished from E. coli of the intestinal microbiota by conventional microbiological tests. METHODS This work presents a two-system multiplex PCR for detection of DEC. Primers for 16S rRNA gene were added as internal amplification control to validate negative reactions. The multiplex-PCR system 1 contains primers for detection of Shiga toxin producing E. coli (STEC; stx1, stx2), enteropathogenic E. coli (EPEC; eae, bfpA), atypical enteropathogenic E. coli (aEPEc; eae), enteroinvasive E. coli (ETEC; lt, st), enteroinvasive E. coli (EIEC; ial), and the internal amplification control 16S rRNA. The system 2 contains primers for EIEC (ipaH), enteroaggregative E. coli (CVD432), diffusely adherent E. coli (daaE), and 16S rRNA. The protocol was tested with E. coli reference strains, and also with cultures of fecal specimens of people with diarrhea and healthy controls. RESULTS The protocol correctly identified the DEC reference strains. No DEC marker was amplified for negative controls; these results were validated by the amplification of a fragment of the 16S rRNA gene. The frequency of DEC was 7.6% for both patients and healthy controls; two Shigella sonnei strains were detected in the group with diarrhea. The identity of the amplicons was confirmed by DNA sequencing. CONCLUSION The protocol is specific for DEC Shigella and is suitable for clinical laboratories.
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18
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Muhsen K, Levine MM. A systematic review and meta-analysis of the association between Giardia lamblia and endemic pediatric diarrhea in developing countries. Clin Infect Dis 2012; 55 Suppl 4:S271-93. [PMID: 23169940 PMCID: PMC3502312 DOI: 10.1093/cid/cis762] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
We performed a systematic literature review and meta-analysis examining the association between diarrhea in young children in nonindustrialized settings and Giardia lamblia infection. Eligible were case/control and longitudinal studies that defined the outcome as acute or persistent (>14 days) diarrhea, adjusted for confounders and lasting for at least 1 year. Data on G. lamblia detection (mainly in stools) from diarrhea patients and controls without diarrhea were abstracted. Random effects model meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Twelve nonindustrialized-setting acute pediatric diarrhea studies met the meta-analysis inclusion criteria. Random-effects model meta-analysis of combined results (9774 acute diarrhea cases and 8766 controls) yielded a pooled OR of 0.60 (95% CI, .38-.94; P = .03), indicating that G. lamblia was not associated with acute diarrhea. However, limited data suggest that initial Giardia infections in early infancy may be positively associated with diarrhea. Meta-analysis of 5 persistent diarrhea studies showed a pooled OR of 3.18 (95% CI, 1.50-6.76; P < .001), positively linking Giardia with that syndrome. The well-powered Global Enteric Multicenter Study (GEMS) is prospectively addressing the association between G. lamblia infection and diarrhea in children in developing countries.
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Affiliation(s)
- Khitam Muhsen
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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19
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20
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Costa MSM, Nogueira PA, Magalhães GF, Taquita P, Mariúba LA, Penatti M, Orlandi PP. Rotavirus genotyping in gastroenteritis cases of an infantile population from Western Brazilian Amazonia. Rev Soc Bras Med Trop 2012; 45:520-2. [DOI: 10.1590/s0037-86822012000400021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 05/17/2011] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: During the period from 2000 to 2002, 79 rotavirus-positive stool samples were collected from children presenting diarrhea in the Western Brazilian Amazon. METHODS: Molecular characterization of the G and P genotypes was performed using RT-PCR and electropherotyping analysis by polyacrylamide gel electrophoresis. RESULTS: A total of 59 samples were confirmed as group A rotavirus. A long electrophoretic profile was exhibited by the G1P[8], G3P[8], and G4P[8] genotypes. The G1P[8] genotype was found in greater proportion. The short electropherotype was exhibited only by G2 genotype strains. CONCLUSIONS: The proportion of the rotavirus genotypes observed was not different from that in other areas of Brazil. This study is the first genotyping of rotavirus in the Western Brazilian Amazon.
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Estrada-Garcia T, Navarro-Garcia F. Enteroaggregative Escherichia coli pathotype: a genetically heterogeneous emerging foodborne enteropathogen. ACTA ACUST UNITED AC 2012; 66:281-98. [PMID: 22775224 DOI: 10.1111/j.1574-695x.2012.01008.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 07/03/2012] [Accepted: 07/03/2012] [Indexed: 11/28/2022]
Abstract
Until now, a common feature that defines the enteroaggregative Escherichia coli (EAEC) strains is the ability to produce a 'stacked-brick' appearance on epithelial cells, but it does not distinguish between pathogenic and nonpathogenic strains. Numerous adhesins, toxins, and proteins associated with virulence have been described, as well as multiple factors contributing to EAEC-induced inflammation. None of these factors are found in all EAEC isolates, and no single factor has ever been implicated in EAEC virulence. The European outbreak of Shiga-toxin-producing EAEC raises its pathogenic potential and interest on finding the true pathogenic factors that may define this pathotype. EAEC were first associated with persistent diarrhea in infants from developing countries, since then they have increasingly been linked as a cause of acute and persistent diarrhea in young infants and children in developing and industrialized countries, individuals infected with human immunodeficiency virus, as a cause of acute diarrhea in travelers from industrialized regions, and with foodborne outbreaks. A major effect of EAEC infection is on the malnourished children in developing countries. Here, we will discuss the EAEC public health relevance and their complexity because of the strain heterogeneity regarding their pathogenesis, identification, diagnosis, lineage, epidemiology, and clinical manifestations.
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Affiliation(s)
- Teresa Estrada-Garcia
- Department of Molecular Biomedicine, Centro de Investigación y de Estudios Avanzados del IPN, México DF, Mexico
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Rodulfo H, De Donato M, Luiggi J, Michelli E, Millán A, Michelli M. Molecular characterization of Salmonella strains in individuals with acute diarrhea syndrome in the State of Sucre, Venezuela. Rev Soc Bras Med Trop 2012; 45:329-33. [PMID: 22760131 DOI: 10.1590/s0037-86822012000300010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 07/29/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In Venezuela, acute diarrheic syndrome (ADS) is a primary cause of morbi-mortality, often involving the Salmonella genus. Salmonella infections are associated with acute gastroenteritis, one of the most common alimentary intoxications, and caused by the consumption of contaminated water and food, especially meat. METHODS Conventional and molecular methods were used to detect Salmonella strains from 330 fecal samples from individuals of different ages and both sexes with ADS. Polymerase chain reaction (PCR) was used for the molecular characterization of Salmonella, using invA, sefA, and fliC genes for the identification of this genus and the serotypes Enteritidis and Typhimurium, respectively. RESULTS The highest frequency of individuals with ADS was found in children 0-2 years old (39.4%), and the overall frequency of positive coprocultures was 76.9%. A total of 14 (4.2%) strains were biochemically and immunologically identified as Salmonella enterica subsp. enterica, of which 7 were classified as belonging to the Enteritidis serotype, 4 to the Typhimurium serotype, and 3 to other serotypes. The S. enterica strains were distributed more frequently in the age groups 3-4 and 9-10 years old. CONCLUSIONS The molecular characterization method used proved to be highly specific for the typing of S. enterica strains using DNA extracted from both the isolated colonies and selective enrichment broths directly inoculated with fecal samples, thus representing a complementary tool for the detection and identification of ADS-causing bacteria.
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Affiliation(s)
- Hectorina Rodulfo
- Laboratório de Genética Molecular, Instituto de Investigaciones en Biomedicina y Ciencias Aplicadas Dra. Suzan Tai, Universidade de Oriente, Cumaná, Sucre, Venezuela
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23
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Ali MMM, Mohamed ZK, Klena JD, Ahmed SF, Moussa TAA, Ghenghesh KS. Molecular characterization of diarrheagenic Escherichia coli from Libya. Am J Trop Med Hyg 2012; 86:866-71. [PMID: 22556089 DOI: 10.4269/ajtmh.2012.11-0330] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Diarrheagenic Escherichia coli (DEC) are important enteric pathogens that cause a wide variety of gastrointestinal diseases, particularly in children. Escherichia coli isolates cultured from 243 diarrheal stool samples obtained from Libyan children and 50 water samples were screened by polymerase chain reaction (PCR) for genes characteristic of enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enterohemorrhagic E. coli (EHEC), and enteroinvasive E. coli (EIEC). The DEC were detected in 21 (8.6%) children with diarrhea; 10 (4.1%) cases were identified as EAEC, 3 (1.2%) as EPEC, and 8 (3.3%) were ETEC; EHEC, and EIEC were not detected. All DEC were grouped phylogenetically by PCR with the majority (> 70%) identified as phylogenetic groups A and B1. The EAEC isolates were also tested for eight genes associated with virulence using PCR. Multi-virulence (≥ 3 virulence factors) was found in 50% of EAEC isolates. Isolated EAEC possessed different virulence traits and belonged to different phylogenetic groups indicating their heterogeneity.
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24
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Barletta F, Ochoa TJ, Mercado E, Ruiz J, Ecker L, Lopez G, Mispireta M, Gil AI, Lanata CF, Cleary TG. Quantitative real-time polymerase chain reaction for enteropathogenic Escherichia coli: a tool for investigation of asymptomatic versus symptomatic infections. Clin Infect Dis 2011; 53:1223-9. [PMID: 22028433 DOI: 10.1093/cid/cir730] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Enteropathogenic Escherichia coli (EPEC) strains are pediatric pathogens commonly isolated from both healthy and sick children with diarrhea in areas of endemicity. The aim of this study was to compare the bacterial load of EPEC isolated from stool samples from children with and without diarrhea to determine whether bacterial load might be a useful tool for further study of this phenomenon. METHODS EPEC was detected by polymerase chain reaction (PCR) of colonies isolated on MacConkey plates from 53 diarrheal and 90 healthy children aged <2 years. DNA was isolated from stool samples by cetyltrimethylammonium bromide extraction. To standardize quantification by quantitative real-time PCR (qRT-PCR), the correlation between fluorescence threshold cycle and copy number of the intimin gene of EPEC E2348/69 was determined. RESULTS The detection limit of qRT-PCR was 5 bacteria/mg stool. The geometric mean load in diarrhea was 299 bacteria/mg (95% confidence interval [CI], 77-1164 bacteria/mg), compared with 29 bacteria/mg (95% CI, 10-87 bacteria/mg) in control subjects (P = .016). Bacterial load was significantly higher in children with diarrhea than in control subjects among children <12 months of age (178 vs 5 bacteria/mg; P = .006) and among children with EPEC as the sole pathogen (463 vs 24 bacteria/mg; P = .006). CONCLUSIONS EPEC load measured by qRT-PCR is higher in diarrheal than in healthy children. qRT-PCR may be useful to study the relationship between disease and colonization in settings of endemicity.
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Affiliation(s)
- Francesca Barletta
- Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical, Lima, Perú
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Andrade JABD, Freymüller E, Fagundes-Neto U. Pathophysiology of enteroaggregative Escherichia coli infection: an experimental model utilizing transmission electron microscopy. ARQUIVOS DE GASTROENTEROLOGIA 2011; 47:306-12. [PMID: 21140095 DOI: 10.1590/s0004-28032010000300018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 01/26/2010] [Indexed: 11/22/2022]
Abstract
CONTEXT Enteroaggregative Escherichia coli strains have been associated with persistent diarrhea in several developing countries. In vivo procedures with animal models as rat, rabbit and gnotobiotic piglets intestinal loops, in vitro assays with cellular lines like T84, Caco 2, HT29, HeLa e HEp-2 and in vitro organ culture with intestinal fragments have been applied to study these bacteria and their pathogenicity. OBJECTIVES The present experimental research assessed the pathogenic interactions of three enteroaggregative Escherichia coli strains, using the in vitro organ culture, in order to observe and compare alterations in different regions of both, the ileal and the colonic mucosa. METHODS This study applied intestinal fragments from terminal ileum and colon that were excised from pediatric and adult patients that underwent colonoscopic procedures. Tissue was fixed for transmission electron microscopic study. Each bacterium was tested with three intestinal fragments for each region. RESULTS Enteroaggregative Escherichia coli strains colonized and provoked citotoxic effects in the ileal and colonic mucosa. Total or partial villi destruction, vacuolization of basal cytoplasm of the enterocytes, epithelium detachment, derangement of the structure and epithelial cell extrusion in ileal mucosa could explain the perpetuation of the diarrhea. Bacterial aggregates were seen in intestinal lumen associated with mucus and cellular debris and in the intercellular spaces of the destroyed epithelium, suggesting bacterial invasion that seemed to be secondary to the destruction of the tissue. CONCLUSIONS Pathogenesis of persistent diarrhea should include alterations in the small bowel structures where the digestive-absorptive functions take place. In the colonic mucosa the inflammatory lesions could explain the occurrence of colitis.
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Rahouma A, Klena JD, Krema Z, Abobker AA, Treesh K, Franka E, Abusnena O, Shaheen HI, El Mohammady H, Abudher A, Ghenghesh KS. Enteric pathogens associated with childhood diarrhea in Tripoli-Libya. Am J Trop Med Hyg 2011; 84:886-91. [PMID: 21633024 DOI: 10.4269/ajtmh.2011.11-0116] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Stool samples from children < 5 years of age with diarrhea (N = 239) were examined for enteric pathogens using a combination of culture, enzyme-immunoassay, and polymerase chain reaction methods. Pathogens were detected in 122 (51%) stool samples; single pathogens were detected in 37.2% and co-pathogens in 13.8% of samples. Norovirus, rotavirus, and diarrheagenic Escherichia coli (DEC) were the most frequently detected pathogens (15.5%, 13.4%, and 11.2%, respectively); Salmonella, adenovirus, and Aeromonas were detected less frequently (7.9%, 7.1%, and 4.2%). The most commonly detected DEC was enteroaggregative E. coli (5.4%). Resistance to ≥ 3 antimicrobials was observed in 60% (18/30) of the bacterial pathogens. Salmonella resistance to ciprofloxacin (63.1%) has become a concern. Enteric viral pathogens were the most significant causative agents of childhood diarrhea in Tripoli. Bacterial pathogens were also important contributors to pediatric diarrhea. The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authorities.
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Affiliation(s)
- Amal Rahouma
- Departments of Microbiology and Immunology, Faculty of Medicine, Alfateh University, Tripoli, Libya.
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de Souza RL, Abreu Carvalhaes JT, Sanae Nishimura L, de Andrade MC, Cabilio Guth BE. Hemolytic uremic syndrome in pediatric intensive care units in são paulo, Brazil. Open Microbiol J 2011; 5:76-82. [PMID: 21804902 PMCID: PMC3143539 DOI: 10.2174/1874285801105010076] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 05/12/2011] [Accepted: 05/12/2011] [Indexed: 01/08/2023] Open
Abstract
The hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC) is one of the most frequent causes of pediatric acute renal failure. The aim of this study was to report the clinic and microbiologic features associated with 13 post-diarrheal HUS cases identified in pediatric intensive care units in the city of São Paulo, Brazil, from January 2001 to August 2005. Epidemiologic, clinic, and laboratorial information, along with fecal and serum samples, were collected for identifying the genetic sequences of Stx and for studying antibodies directed against LPS O26, O111 and O157. STEC was isolated from three patients, and serotypes O26:H11, O157:H7 and O165:H- were identified. In nine patients, high levels of IgM against LPS O111 (n=2) and O157 (n=7) were detected. Dialysis was required in 76.9% of the patients; arterial hypertension was present in 61.5%, neurological complications were observed in 30.7%, and only one patient died. During a 5-year follow-up period, one patient developed chronic kidney disease. The combined use of microbiologic and serologic techniques provided evidence of STEC infection in 92.3% of the HUS cases studied, and the importance of O157 STEC as agents of HUS in São Paulo has not been previously highlighted.
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Affiliation(s)
- Renato Lopes de Souza
- Pediatric Intensive Care Unit, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
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Nunes M, Penna F, Franco R, Mendes E, Magalhães P. Enterotoxigenic Escherichia coli in children with acute diarrhoea and controls in Teresina/PI, Brazil: distribution of enterotoxin and colonization factor genes. J Appl Microbiol 2011; 111:224-32. [DOI: 10.1111/j.1365-2672.2011.05031.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Scaletsky ICA, Souza TB, Aranda KRS, Okeke IN. Genetic elements associated with antimicrobial resistance in enteropathogenic Escherichia coli (EPEC) from Brazil. BMC Microbiol 2010; 10:25. [PMID: 20105329 PMCID: PMC2828443 DOI: 10.1186/1471-2180-10-25] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Accepted: 01/27/2010] [Indexed: 12/30/2022] Open
Abstract
Background We recently observed an association of resistance with a certain enteropathogenic Escherichia coli (EPEC) serotypes and identified a conjugative plasmid, similar to plasmid pED208, that was conserved among archival O111:H2/NM and O119:H2 strains of diverse geographical origin. In this study, we sought to determine the prevalence and distribution of this plasmid among a collection of EPEC isolates from Brazil, as well as to study the susceptibilities of these isolates to antimicrobial agents. Results Resistance was more commonly seen in typical EPEC than atypical strains. The most prevalent resistances were to ampicillin, tetracycline, streptomycin and the sulfonamides. Markers for the EPEC conjugative multiresistance plasmid, were detected in 21 (30%) of typical but only 4 (5%) of atypical strains (p = 0.001, Chi-squared test). This plasmid, previously reported from only O111 and O119 strains was found in O55 and O127 strains and was associated with the presence of class 1 integrons. Conclusion Our data suggest a limited but expanding host range for the EPEC resistance plasmid.
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Affiliation(s)
- Isabel C A Scaletsky
- Departamento de Microbiologia, Universidade Federal de São Paulo, Rua Botucatu 862, São Paulo 04023-062, Brazil.
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Ochoa TJ, Ecker L, Barletta F, Mispireta ML, Gil AI, Contreras C, Molina M, Amemiya I, Verastegui H, Hall ER, Cleary TG, Lanata CF. Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Peru. Clin Infect Dis 2009; 49:1694-702. [PMID: 19857163 PMCID: PMC2779581 DOI: 10.1086/648069] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants. METHODS We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction. RESULTS The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants aged >or=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P <.05). Children aged >or=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged <6 months (13.5% vs 3.6%; P <.001). Among children with diarrheagenic E. coli-positive samples, coinfections with other pathogens were more common in children with diarrhea than in control children (40.1% vs 15.6%; P <.001). CONCLUSIONS Diarrheagenic E. coli strains were more frequently isolated in samples from older infants. In this setting with high frequency of pathogen exposure and high frequency of breastfeeding, we hypothesize that the major age-related differences result from decreased exposure to milk-related protective factors and from increased exposure to contaminated food and water.
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Affiliation(s)
- Theresa J. Ochoa
- Universidad Peruana Cayetano Heredia, Lima, Perú
- University of Texas School of Public Health, Houston, USA
| | - Lucie Ecker
- Instituto de Investigación Nutricional, Lima, Perú
| | | | | | - Ana I. Gil
- Instituto de Investigación Nutricional, Lima, Perú
| | | | | | | | | | - Eric R. Hall
- Naval Medical Research Center Detachment (NMRCD), Lima, Perú
| | | | - Claudio F. Lanata
- Instituto de Investigación Nutricional, Lima, Perú
- Universidad Peruana de Ciencias Aplicadas, Lima, Perú
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Simpore J, Ouermi D, Ilboudo D, Kabre A, Zeba B, Pietra V, Pignatelli S, Nikiema JB, Kabre GB, Caligaris S, Schumacher F, Castelli F. Aetiology of acute gastro-enteritis in children at Saint Camille Medical Centre, Ouagadougou, Burkina Faso. Pak J Biol Sci 2009; 12:258-63. [PMID: 19579955 DOI: 10.3923/pjbs.2009.258.263] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The present study aims at identifying the infectious agents responsible for child Acute GastroEnteritis (AGE) in Ouagadougou. From May 5 2006 to June 22 2008, 648 children aged from 2 to 41 months, with at least an average of 3 loose stools per day have been enrolled for coproculture, parasitology and virology test. Among them, 34 (5.25%) were HIV seropositive. A single sample of faeces from each child was used to identify enteropathogens. An infectious aetiology was identified in 41.20% of cases. The pathogenic agents detected as responsible for the AGE are: Rotavirus 21.1%; Adenovirus 1.9%; Giardia 7.6% Entamoeba; 1.08%; entero-pathogenic E. coli 41.7%; Salmonella 3.40%; Shigella 1.85% and Yersinia 1.70%. CONCLUSION Therefore, these AGE etiologic agents constitute a problem of public health in Burkina Faso. Their control for the child would require: (1) a regular paediatric and clinical follow up; (2) health education of the population for food hygiene and (3) in case of absence of HIV infection in the mother, a promotion of exclusive breast-feeding up to the age of 4 months.
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Affiliation(s)
- J Simpore
- Medical Centre, Saint Camille-Pietro Annigoni Biomolecular Research Centre, Saint Camille-Cerba/Labiogene-Ouagadougou, Burkina Faso, 01 BP 364 Ouagadougou, 01 Burkina Faso, Italy
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Hernandes RT, Elias WP, Vieira MAM, Gomes TAT. An overview of atypical enteropathogenic Escherichia coli. FEMS Microbiol Lett 2009; 297:137-49. [PMID: 19527295 DOI: 10.1111/j.1574-6968.2009.01664.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The enteropathogenic Escherichia coli (EPEC) pathotype is currently divided into two groups, typical EPEC (tEPEC) and atypical EPEC (aEPEC). The property that distinguishes these two groups is the presence of the EPEC adherence factor plasmid, which is only found in tEPEC. aEPEC strains are emerging enteropathogens that have been detected worldwide. Herein, we review the serotypes, virulence properties, genetic relationships, epidemiology, reservoir and diagnosis of aEPEC, including those strains not belonging to the classical EPEC serogroups (nonclassical EPEC serogroups). The large variety of serotypes and genetic virulence properties of aEPEC strains from nonclassical EPEC serogroups makes it difficult to determine which strains are truly pathogenic.
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Affiliation(s)
- Rodrigo T Hernandes
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Brazil
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Silva T, Nogueira PA, Magalhães GF, Grava AF, Silva LHPD, Orlandi PP. Characterization of Shigella spp. by antimicrobial resistance and PCR detection of ipa genes in an infantile population from Porto Velho (Western Amazon region), Brazil. Mem Inst Oswaldo Cruz 2009; 103:731-3. [PMID: 19057826 DOI: 10.1590/s0074-02762008000700017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Accepted: 09/08/2008] [Indexed: 05/25/2023] Open
Abstract
The incidence of Shigella spp. was assessed in 877 infants from the public hospital in Rondônia (Western Amazon region, Brazil) where Shigella represents the fourth cause of diarrhea. Twenty-five isolates were identified: 18 were Shigella flexneri, three Shigella sonnei, three Shigella boydii and one Shigella dysenteriae. With the exception of S. dysenteriae, all Shigella spp. isolated from children with diarrhea acquired multiple antibiotic resistances. PCR detection of ipa virulence genes and invasion assays of bloody diarrhea and fever (colitis) were compared among 25 patients testing positive for Shigella. The ipaH and ipaBCD genes were detected in almost all isolates and, unsurprisingly, all Shigella isolates associated with colitis were able to invade HeLa cells. This work alerts for multiple antibiotic resistant Shigella in the region and characterizes presence of ipa virulence genes and invasion phenotypesin dysenteric shigellosis.
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Affiliation(s)
- Tatiane Silva
- Centro de Pesquisa em Medicina Tropical, Porto Velho, RO, Brasil
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De Toni F, de Souza EM, Pedrosa FO, Klassen G, Irino K, Un Rigo L, Steffens MBR, Fialho OB, Farah SMSS, Fadel-Picheth CMT. A prospective study on Shiga toxin-producing Escherichia coli in children with diarrhea in Paraná State, Brazil. Lett Appl Microbiol 2009; 48:645-7. [PMID: 19228288 DOI: 10.1111/j.1472-765x.2009.02569.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To examine stool specimens from children with diarrhea from Paraná State, southern Brazil, for presence of STEC. METHODS AND RESULTS A PCR screening assay for stx genes was used to examine a loopful of confluent colonies of 306 stool samples cultures. In six (1.96%) of them, DNA fragments of the expected size were observed, and the presence of stx was confirmed by DNA sequencing. Then up to 100 single colonies from each of the six stool cultures were analyzed using the same PCR protocol. However, stx-positive colonies were found only in two of the cultures. The E. coli strains belonged to serotypes O69:H11 and O178:H19, and presented genotypes stx(1)eae ehxA and stx(1) respectively. Shiga toxin production was confirmed using the VTEC Screen Seiken. Except ampicillin, they were susceptible to all the antimicrobials tested. CONCLUSIONS These results show that STEC may be an important cause of diarrhea in children of Paraná State, and that they are present in low numbers in stools. The strains belonged to serotypes not commonly found associated with STEC and probably present low virulence. SIGNIFICANCE AND IMPACT OF STUDY These results indicate that molecular methods are required to diagnosis of STEC infections.
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Affiliation(s)
- F De Toni
- Department of Medical Pathology, Federal University of Paraná, Curitiba, PR, Brazil
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Djeneba O, Damintoti K, Denise I, Christelle NWM, Virgilio P, Adrien B, Jacques S, Gustave K, Salvatore P, Laya S. Prevalence of rotavirus, adenovirus and enteric parasites among pediatric patients attending Saint Camille Medical Centre in Ouagadougou. Pak J Biol Sci 2009; 10:4266-70. [PMID: 19086583 DOI: 10.3923/pjbs.2007.4266.4270] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study carried out in the Saint Camille Medical Centre of Ouagadougou and related to the prevalence of Rotaviruses, Adenoviruses and enteric parasites infections among HIV-seropositive and HIV-seronegative children allowed to include 66 children aged from 2 to 60 months presenting acute diarrhea. The results revealed that 10.60% were infected by HIV. Stool samples analysis by direct microscopy and immunochromatographic tests (Rota-strip and Adeno-strip) showed 42.42% of global infections, among these, 18.18% parasitic infections and 24.24% viral infections, predominantly rotaviruses (22.73 and 1.52% for Rotaviruses and Adenoviruses, respectively). Among parasitic infections, Protozoan were most common than Helminthes (12.12% versus 6.06%). According to present results, Rotaviruses appeared as the major etiological agents in children aged from 2 to 11 months. However high rate of protozoan and helminthes was found in children aged from 12 to 60 months. Thus, virus, particularly Rotavirus must be painstaking as the principal etiologic agent of infant diarrhea in our country.
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Affiliation(s)
- Ouermi Djeneba
- Laboratoire de Biologie Médicale, Saint Camille de Ouagadougou, Burkina Faso
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Phylogenetic backgrounds and virulence profiles of atypical enteropathogenic Escherichia coli strains from a case-control study using multilocus sequence typing and DNA microarray analysis. J Clin Microbiol 2008; 46:2280-90. [PMID: 18463209 DOI: 10.1128/jcm.01752-07] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Atypical enteropathogenetic Escherichia coli (EPEC) strains are frequently detected in children with diarrhea but are also a common finding in healthy children. The aim of this study was to compare the phylogenetic ancestry and virulence characteristics of atypical (eae positive, stx and bfpA negative) EPEC strains from Norwegian children with (n = 37) or without (n = 19) diarrhea and to search for an association between phylogenetic ancestry and diarrhea. The strains were classified in phylogenetic groups by phylogenetic marker genes and in sequence types (STs) by multilocus sequence typing. Phylogenetic ancestry was compared to virulence characteristics based on DNA microarray analysis. Serotyping and pulsed-field gel electrophoresis (PFGE) were also performed. All four phylogenetic groups, 26 different STs, and 20 different clonal groups were represented among the 56 atypical EPEC strains. The strains were separated into three clusters by overall virulence gene profile; one large cluster with A, B1, and D strains and two clusters with group B2 strains. There was considerable heterogeneity in the PFGE profiles and serotypes, and almost half of the strains were O nontypeable. The efa1/lifA gene, previously shown to be statistically linked with diarrhea in this strain collection (J. E. Afset et al., J. Clin. Microbiol. 44:3703-3711, 2006), was present in 8 of 26 STs. The two phylogenetic groups B1 and D were weakly associated with diarrhea (P = 0.06 and P = 0.09, respectively). In contrast, group B2 was isolated most frequently from healthy controls (P = 0.05). In conclusion, the atypical EPEC strains were heterogeneous both phylogenetically and by virulence profile. Phylogenetic ancestry was less useful as a predictor of diarrhea than were specific virulence genes.
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Albuquerque MCM, Rocha LN, Benati FJ, Soares CC, Maranhão AG, Ramírez ML, Erdman D, Santos N. Human bocavirus infection in children with gastroenteritis, Brazil. Emerg Infect Dis 2008; 13:1756-8. [PMID: 18217564 DOI: 10.3201/eid1311.070671] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Human bocavirus (HBoV) was detected in 14 (2%) of 705 fecal specimens from Brazilian children with gastroenteritis. Coinfection with rotavirus, adenovirus, or norovirus was found in 3 (21.4%) HBoV-positive specimens. None of the HBoV-positive patients had respiratory symptoms.
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Diarrheagenic Escherichia coli and Shigella strains isolated from children in a hospital case-control study in Hanoi, Vietnam. J Clin Microbiol 2008; 46:996-1004. [PMID: 18174300 DOI: 10.1128/jcm.01219-07] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This case-control study detected and characterized Shigella and diarrheagenic Escherichia coli (DEC) types among Vietnamese children less than 5 years old. In 249 children with diarrhea and 124 controls, Shigella spp. was an important cause of diarrhea (P < 0.05). We used multiplex PCR and DNA probes to detect enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAggEC), enteropathogenic E. coli (EPEC), attaching and effacing E. coli (A/EEC), verocytotoxin-producing E. coli (VTEC), and enterotoxigenic E. coli (ETEC). The prevalences of DEC in the diarrhea and control groups were 25.7 and 10.5%, respectively. In 62 children with diarrhea, 64 DEC strains included 22 EAggEC (8.8%), 2 EIEC (0.8%), 23 A/EEC (9.2%), 7 EPEC (2.8%), and 10 ETEC strains (4.0%). Among controls, 13 DEC strains included 5 EAggEC strains (4.0%), 7 A/EEC strains (5.6%), and 1 EPEC strain. The characterization of DEC by serotypes, antimicrobial susceptibility patterns, virulence genes, and pulsed-field gel electrophoresis showed the occurrence of many different and highly heterogenic DEC subtypes, but common serotypes were found among ETEC, EIEC and EPEC, respectively. Serotyping was used to distinguish between A/EEC and EPEC. However, A/EEC, EPEC, and EAggEC were isolated at high frequency from both cases and controls. Further in-depth studies are needed to better understand important virulence factors of DEC, especially A/EEC, EPEC, and EAggEC.
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Hien BTT, Trang DT, Scheutz F, Cam PD, Mølbak K, Dalsgaard A. Diarrhoeagenic Escherichia coli and other causes of childhood diarrhoea: a case-control study in children living in a wastewater-use area in Hanoi, Vietnam. J Med Microbiol 2007; 56:1086-1096. [PMID: 17644717 DOI: 10.1099/jmm.0.47093-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A case-control study was conducted to identify the aetiology of diarrhoeal diseases in pre-school children in a suburban area of Hanoi where the use of untreated wastewater in agriculture and aquaculture is a common practice. Stool specimens and clinical information were collected from 111 pairs of children with diarrhoea and healthy controls. A total of 73 cases (66 %) and 41 controls (36 %) had an enteric pathogen. The pathogens most often associated with diarrhoea were rotavirus (17 % of cases) and Entamoeba histolytica (15 %), followed by Shigella (5 %). Diarrhoeagenic Escherichia coli (DEC) was found in 23 % of both patients and controls. Characterization of DEC by serotyping, antimicrobial susceptibility test and PFGE showed that DEC represented by different pathotypes belonged to various serotypes. Except for three enterotoxigenic E. coli strains, typing by PFGE revealed no correlation between pathotype and serotype of DEC strains. This suggests a high prevalence of a variety of DEC subtypes in this area. For this particular region, vaccine development strategies targeting rotavirus and Shigella are likely to be of public health benefit, whereas the role of DEC and preventive measures need to be further elaborated.
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Affiliation(s)
- Bui Thi Thu Hien
- Department of Veterinary Pathobiology, Faculty of Life Science, Copenhagen University, Frederiksberg, Denmark
- Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Do Thuy Trang
- Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Flemming Scheutz
- International Escherichia and Klebsiella Centre (WHO), Department of Bacteriology, Mycology, and Parasitology, Statens Serum Institut, Copenhagen, Denmark
| | - Phung Dac Cam
- Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Kåre Mølbak
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Dalsgaard
- Department of Veterinary Pathobiology, Faculty of Life Science, Copenhagen University, Frederiksberg, Denmark
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Magalhães GF, Nogueira PA, Grava AF, Penati M, Silva LHPD, Orlandi PP. Rotavirus and adenovirus in Rondônia. Mem Inst Oswaldo Cruz 2007; 102:555-7. [PMID: 17710298 DOI: 10.1590/s0074-02762007005000067] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 05/28/2007] [Indexed: 11/22/2022] Open
Abstract
Acute gastroenteritis is one of the most common diseases in humans worldwide. Viral gastroenteritis is a global problem in infants and young children. In this study the incidence of diarrhea was assessed in 877 hospitalized children under five years old, over a period of 24 months and distributed in 470 cases of diarrhea and 407 age-matched group with other pathologies, as control group. Two antigen detection techniques based on enzyme immunoassay (EIA) and latex particles were used for detection of rotavirus and adenovirus. Rotavirus A was a major cause of gastroenteritis with 23.6% of cases, being 90% of these cases in young children. Adenovirus infections was detected by EIA with frequency of 6.4%. Rotavirus and adenovirus were detected in 10.1 and 1.7% of stools from control group, respectively. Interestingly, the frequency of the youngest children in the control group excreting Rotavirus A was comparable to that detected in stools from diarrheic children. We cannot rule out the existence of other enteric viruses because the etiology of 171 cases of diarrhea was not determined and active search for astrovirus and calicivirus was not done. This is the first study that shows the presence of enteric viruses in the infantile population from Western Brazilian Amazonia and it was important to help physicians in the treatment of viral gastroenteritis.
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